The Institute for Family Health, which operates a diverse network of 16 federally-qualified community health centers in New York State, proposes to conduct a multi-method study of the implementation and impact of its transformation to a patient-centered home model of care (PCMH). This model has high potential to improve health care quality and engage patients. The study's research team includes Institute leaders and partners at the New York Academy of Medicine and Drexel University. The goal of the study is to inform the efforts of CHCs and primary care practices as they strive to adopt the PCMH model. Specific project aims are to: * Identify and describe processes of care, their financial costs, and other resource requirements; * Examine and validate changes in health service utilization and outcomes among patients, with a focus on diabetes, depression and hyperlipidemia, that resulted from the implementation of the PCMH model;and * Explicate the organizational, contextual, procedural and other variables within the Institute and its individual health centers that impacted on the implementation of the PCMH model and improvements in care. Research Design: This study will incorporate individual, provider and site data collected from the Institute's electronic health record system;in-depth interviews with patients, administrators, providers and staff;and reviews of secondary source documents. Qualitative methods will be used to identify implementation processes, workflow changes, perceptions of change, resource requirements, contextual factors, and linkages and pathways between system, individual and site level practice change. Quantitative methods will focus on measures of change in practice consistent with PCMH standards, changes in service utilization at the patient level, improvements in health outcomes, and costs associated with these changes. PUBLIC HEALTH RELEVANCE: The Institute for Family Health, which operates a diverse network of 16 federally-qualified community health centers in New York State, proposes to conduct a rigorous multi-method study of the implementation and impact of its transformation to a patient-centered home model of care (PCMH). Despite limited evidence, the PCMH model is viewed as having high potential to improve health care quality and engage patients, and uptake of the model and related reimbursement incentives is accelerating. The study findings will inform the efforts of CHCs and other primary care practices as they strive to adopt the PCMH model.